| NPI | 1558614388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE LEE President 325-692-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Additional Taxonomies | 261Q00000X |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2021-04-08 |